Cerebral radiation necrosis: incidence, outcomes, and risk factors with emphasis on radiation parameters and chemotherapy

International Journal of Radiation Oncology, Biology, Physics
Jeremy D RubenPasqual Fedele

Abstract

To investigate radiation necrosis in patients treated for glioma in terms of incidence, outcomes, predictive and prognostic factors. Records were reviewed for 426 patients followed up until death or for at least 3 years. Logistic regression analysis was performed to identify predictive and prognostic factors. Multivariate survival analysis was conducted using Cox proportional hazards regression. Separate analyses were performed for the subset of 352 patients who received a biologically effective dose (BED) > or =85.5 Gy2 (> or =45 Gy/25 fractions) who were at highest risk for radionecrosis. Twenty-one patients developed radionecrosis (4.9%). Actuarial incidence plateaued at 13.3% after 3 years. In the high-risk subset, radiation parameters confirmed as risk factors included total dose (p < 0.001), BED (p < 0.005), neuret (p < 0.001), fraction size (p = 0.028), and the product of total dose and fraction size (p = 0.001). No patient receiving a BED <96 Gy2 developed radionecrosis. Subsequent chemotherapy significantly increased the risk of cerebral necrosis (p = 0.001) even when adjusted for BED (odds ratio [OR], 5.8; 95% confidence interval [CI], 1.6-20.3) or length of follow-up (OR, 5.4; 95% CI, 1.5-19.3). Concurrent use of val...Continue Reading

References

Jul 1, 1976·Archives of Neurology·W R Shapiro, D F Young
Oct 1, 1979·International Journal of Radiation Oncology, Biology, Physics·M D WalkerG E Sheline
Mar 1, 1979·International Journal of Radiation Oncology, Biology, Physics·S A AristizabalJ F Laguna
Aug 1, 1977·The British Journal of Radiology·S B Field, S Hornsey
Feb 1, 1976·The British Journal of Radiology·S SmithM J Peckham
Oct 1, 1992·Journal of Neurology, Neurosurgery, and Psychiatry·P J Grattan-SmithA O Langlands
Jan 1, 1992·International Journal of Radiation Oncology, Biology, Physics·J M TaylorR S Lavey
Oct 1, 1990·Journal of Neurosurgery·O al-MeftyR R Smith
Mar 1, 1988·Neurosurgery·R J CoffeyF H Taylor
Nov 1, 1987·Journal of Neurology, Neurosurgery, and Psychiatry·E WooC Y Huang
Feb 1, 1986·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·T HerrmannU Johanssen
Jan 1, 1986·Journal of Neuro-oncology·M S MahaleyL Bertsch
Jan 1, 1985·Journal of Neuro-oncology·R SoffiettiD Schiffer
Mar 1, 1970·The British Journal of Radiology·J W Hopewell, E A Wright
Feb 1, 1981·International Journal of Radiation Oncology, Biology, Physics·J E MarksW F Blank
Jan 1, 1982·Acta Radiologica. Oncology·M SouthardR L White
Dec 1, 1984·Journal of Neurology, Neurosurgery, and Psychiatry·P J Shaw, D Bates
Sep 1, 1980·International Journal of Radiation Oncology, Biology, Physics·G E ShelineV Smith
Dec 1, 1981·Southern Medical Journal·C Araoz, A M Weems
Mar 1, 1995·Journal of Neurosurgery·P A ForsythE J Atkinson
Jul 1, 1993·Journal of Neuro-oncology·R BabuG N Budzilovich
Jan 9, 1998·International Journal of Radiation Oncology, Biology, Physics·A W LeeJ H Ho
Mar 5, 1999·International Journal of Oral and Maxillofacial Surgery·K M Coghlan, P Magennis

❮ Previous
Next ❯

Citations

Jun 23, 2009·Cancer Chemotherapy and Pharmacology·J Lee VillanoLinda R Bressler
Nov 7, 2008·Brain Tumor Pathology·Yoshihiko Yoshii
Mar 13, 2012·Journal of Neuro-oncology·Sanath KumarStephen L Brown
Apr 29, 2010·Current Oncology Reports·Sajeve S Thomas, Erin M Dunbar
Apr 29, 2010·Current Oncology Reports·Patrick Y WenEudocia Quant
Jul 10, 2009·Current Pain and Headache Reports·Christopher Loiselle, Jason Rockhill
Oct 12, 2010·Current Pain and Headache Reports·Samuel A GoldlustEdward K Avila
Sep 16, 2010·Current Treatment Options in Neurology·Pierre Giglio, John Lee Villano
Jan 17, 2012·Medical Oncology·Madhava R KanakamedalaSantosh Kesari
Jan 12, 2013·Medical Oncology·J Lee VillanoHerbert H Engelhard
Sep 25, 2009·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·S C Short
Oct 7, 2009·Nature Reviews. Clinical Oncology·Isaac Yang, Manish K Aghi
Apr 19, 2013·Neuro-oncology·Benedikt WiestlerUNKNOWN Neuro-oncology Working Group (NOA) of the German Cancer Society
Dec 15, 2010·Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology·Anthony A Mikulec, Laurence J Kinsella
Nov 9, 2011·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Christina I TsienTheodore Lawrence
Sep 29, 2011·Radiation Oncology·Adam GladwishCynthia Ménard
Nov 13, 2012·Radiation Oncology·Henrik HauswaldStephanie E Combs
Mar 24, 2009·Journal of Neurosurgery·Brian J WilliamsGanesh Rao
Dec 3, 2010·Surgical Neurology International·Lola B ChamblessKyle D Weaver
Nov 19, 2013·Pharmaceutical Patent Analyst·Gerardo CarusoMaria Caffo
Nov 12, 2013·Journal of Neurosurgery. Pediatrics·Lauren WeintraubAdam S Levy
Jan 2, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Mario AmmiratiJohn Grecula
Jan 21, 2014·Journal of Neuroradiology. Journal De Neuroradiologie·A MartinoS Grand
May 23, 2013·Pharmacology & Therapeutics·Tareq A JuratliDietmar Krex
Jul 7, 2014·Current Oncology Reports·Barbara J O'Brien, Rivka R Colen
Mar 29, 2014·Journal of Radiation Research·Erina YoritsuneShin-Ichi Miyatake
Oct 15, 2014·Neuro-oncology·Benjamin M EllingsonTimothy F Cloughesy
Sep 15, 2012·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Ritu ShahJoel K Curé
Apr 17, 2014·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·N OkerP Herman
Aug 22, 2013·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·V StrengerC Urban
Jul 6, 2014·International Journal of Molecular Sciences·Kashif ParvezGelareh Zadeh
Jun 7, 2012·Expert Opinion on Investigational Drugs·Sharon BerendsenPierre Robe
Oct 4, 2014·Acta Oncologica·Daniel J IndelicatoNancy P Mendenhall
Oct 21, 2014·Acta Oncologica·Torunn I YockAnita Mahajan
Sep 19, 2015·Clinical Oncology : a Journal of the Royal College of Radiologists·C GzellM Back
Jun 25, 2013·International Journal of Radiation Oncology, Biology, Physics·Samuel T ChaoJohn H Suh
May 2, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·David F SlottjeRicardo J Komotar

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.